15-Year Retrospective Study on the Success Rate of Maxillary Sinus Augmentation and Implants: Influence of Bone Substitute Type, Presurgical Bone Height, and Membrane Perforation during Sinus Lift.

Objectives: To evaluate the success rate of bone grafts and implants carried out at the Latin American Institute for Research and Dental Education (ILAPEO), considering the following: (i) the different pure bone substitutes (autogenous, xenogeneic, and alloplastic), (ii) the presurgical bone height, and (iii) how the treatment is compromised when membrane perforation occurs during sinus lift in maxillary sinus surgeries. Material and Methods. The initial sample comprised 1040 records of maxillary sinus lifting surgeries. After evaluation, the final sample retained 472 grafts performed using the lateral window technique with a total of 757 implants. The grafts were divided into 3 groups: (i) autogenous bone (n = 197), (ii) xenogenous bovine bone (n = 182), and (iii) alloplastic material (n = 93). One calibrated examiner classified the sample into two groups based on the residual bone height (<4 mm and ≥4 mm) of the area of interest measured on parasagittal sections of tomographic images. Data on membrane perforation occurrences in each group were collected; qualitative variables were described using frequency, expressed as percentages. The Chi-square test was used to analyze the success of the graft types and the survival rate of the implants as a function of the grafted material and the residual bone height. The Kaplan-Meier survival analysis was used to calculate the survival rate of bone grafts and implants according to the classifications adopted in this retrospective study. Results: The success rate of grafts and implants was 98.3% and 97.2%, respectively. There was no statistically significant difference in the success rate among the different bone substitutes (p = 0.140). Only 8 grafts (1.7%) and 21 implants (2.8%) failed. There was a greater success rate for both grafts (96.5%) and implants (97.4%) when the bone height was ≥4 mm. The success rate in the 49 sinuses in which the membrane was perforated was 97.96% for the grafts and 96.2% for the implants. The follow-up periods after rehabilitation ranged from 3 months to 13 years. Conclusions: Within the limitations of the data analyzed in this retrospective study, maxillary sinus lift was a viable surgical technique that enabled implant placement with a predictable long-term success rate, regardless of the type of material used. The presence of membrane perforation did not interfere with the success rate obtained for grafts and implants.

Epidemiologia espacial e a detecção de aglomerados espaciais do dengue na Paraíba: uma comparação entre os métodos Scan flexível e Scan circular / Spatial epidemiology and the detection of spatial clusters of dengue in Paraíba: a comparison between the flexible Scan and circular Scan methods

Resumo Introdução Estatísticas espaciais são usadas para auxiliar gestores de saúde na tomada de decisão, informando a taxa de ocorrência de agravos na população e destacando quando estas alcançam valores além do esperado. Objetivo Compreender o funcionamento e aplicabilidade das Estatísticas Espaciais Scan flexível e Scan circular, comparando seus resultados na detecção de aglomerados espaciais usando dados epidemiológicos reais do dengue no estado da Paraíba - Brasil. Método Descreveu-se o processo detalhado da aplicação das estatísticas Scan flexível e Scan circular para a detecção de áreas significativas de risco (aglomerados) do dengue na Paraíba, nos anos de 2009 a 20013, por meio dos software FLeXScan e SaTScan. Resultados Ambos os métodos revelaram o oeste do estado como a região com maior frequência de aglomerados detectados com alto risco, em todos os anos analisados, levando-se em consideração os mapas de risco de incidência do dengue na Paraíba, nos anos de 2009 a 2013. Conclusão As estatísticas Scan flexível e Scan circular são praticamente similares quanto à eficiência na detecção de aglomerados do dengue. Entretanto, verificaram-se problemas de superestimação no método Scan circular e subestimação no método Scan flexível na detecção dos aglomerados. Destacou-se ainda o auxílio destas estatísticas espaciais aos gestores de saúde quanto à localização das regiões de agravo da doença, tornando mais efetivo o direcionamento das ações de combate de forma politicamente correta.

Abstract Background Spatial statistics are used to help health managers make decisions, informing the rate of occurrence of diseases in the population and highlighting when they reach values beyond expectations. Objective To understand the functioning and applicability of Spatial Statistics Flexible Scan and Circular Scan by comparing their results in the detection of spatial clusters using real epidemiological data of dengue in the state of Paraíba - Brazil. Method The detailed process for applying the flexible scan and circular scan statistics for detecting significant dengue risk areas (clusters) in Paraíba, between 2009 and 20013, was described using the software FLeXScan and SaTScan. Results Both methods showed the highest frequency of clusters detected at high risk in the western region of the state, in all the years analyzed, considering the risk maps of dengue incidence in Paraíba, between 2009 and 2013. Conclusion The flexible scan and circular scan statistics are practically similar in terms of efficiency in detecting clusters of dengue. However, there were problems of overestimation in the circular Scan method and underestimation in the flexible Scan method in the detection of clusters. It is also worth highlighting that these spatial statistics help health managers locate the regions of disease aggravation, making it more effective to direct combat actions in a politically correct manner.

Direct costs of rescue procedures to manage vascular access complications in conventional hemodialysis.

OBJECTIVE: To measure the average direct cost of procedures performed by health professionals, in a Dialysis Center, for the management of complications of vascular access for hemodialysis. METHOD: Quantitative, exploratory-descriptive case study type research. The average direct cost was calculated by multiplying the time spent by health professionals by the unit cost of direct labor, adding this to the input costs (materials/ medicines/solutions). RESULTS: The following average direct costs were obtained: US$0.72, US$2.00 and US$1.41 for "administration of easy-to-dilute, difficult-to-dilute, and undiluted antibiotics", respectively; $2.61 for "central venous catheter dressing with topical antibiotic"; $48.05 for "alteplase infusion"; US$183.68 for "insertion of central venous catheter for hemodialysis"; and $1.31 for "arteriovenous fistula puncture". CONCLUSION: Material and drug costs significantly contributed to the composition of the average total direct cost of most procedures.

Can Implant-Retained Fixed Prostheses Trigger Bone Response in the Posterior Region of Edentulous Mandibles? A 32-Month Cone-Beam Computerized Tomography Study Analyzing Bone Height and Density.

Research has shown that the presence of implants can revert bone resorption and thus contribute to a greater preservation of the residual bone ridge, especially in edentulous mandibles. Bone remodeling has yet to be extensively studied in the context of prosthetic options for edentulous arches. This study aims to evaluate the long-term behavior of bone tissue in the posterior region of edentulous mandibles rehabilitated with implant-retained fixed prostheses using cone-beam computerized tomography (CBCT). Selected individuals were rehabilitated with 5 external hexagon platform implants and an implant-retained fixed prosthesis. The CBCT scans were performed immediately after surgery and after 8, 22, and 32 months (T0, T8, T22, and T32, respectively). Implants were installed between the mental foramen. Subsequently, bone crest height and density were measured in the posterior region of the mandible on the images in 3 distinct areas at 5, 10, and 15 mm from the center of the distal implant axis. Analysis of variance and the Bonferroni post hoc test were used for multiple analyses. The results indicate a statistically significant difference in bone height between T0 and all subsequent times; the bone height at T32 was 8.85% higher than at T0 (P = .05). There was a difference in bone height between all analyzed regions. The bone growth difference between the 5-mm and 15-mm positions was 28.42% after 32 months (P = .00). A significant increase of 5.76% in bone density was observed between T0 and T22 (P = .03). Within the limitations of this study (sample size, follow-up duration), it was demonstrated that the use of implant-retained fixed prostheses in the mandible resulted in qualitative and quantitative bone growth (bone preservation) in the posterior region of the mandible. Further research is needed to identify the validity of our findings for other populations and to determine the duration of the bone-remodeling process in rehabilitated edentulous mandibles.

Acute disseminated encephalomyelitis in a COVID-19 pediatric patient.

The authors present a case of acute disseminated encephalomyelitis in a COVID-19 pediatric patient with positive SARS-CoV2 markers from a nasopharyngeal swab. A previously healthy 12-year-old-girl presented with a skin rash, headache, and fever. Five days after that, she had an acute, progressive, bilateral, and symmetrical motor weakness. She evolved to respiratory failure. Magnetic resonance imaging (MRI) of the brain and cervical spine showed extensive bilateral and symmetric restricted diffusion involving the subcortical and deep white matter, a focal hyperintense T2/FLAIR lesion in the splenium of the corpus callosum with restricted diffusion, and extensive cervical myelopathy involving both white and gray matter. Follow-up examinations of the brain and spine were performed 30 days after the first MRI examination. The images of the brain demonstrated mild dilatation of the lateral ventricles and widespread widening of the cerebral sulci, complete resolution of the extensive white matter restricted diffusion, and complete resolution of the restricted diffusion in the lesion of the splenium of the corpus callosum, leaving behind a small gliotic focus. The follow-up examination of the spine demonstrated nearly complete resolution of the extensive signal changes in the spinal cord, leaving behind scattered signal changes in keeping with gliosis. She evolved with partial clinical and neurological improvement and was subsequently discharged.

Custo direto da inserção de cateter venoso central para realização de hemodiálise convencional / Costo directo de la inserción de catéter venoso central para realización de la hemodiálisis convencional / Direct cost of central venous catheter insertion for conventional hemodialysis

RESUMO Objetivo: identificar o custo direto médio da inserção de cateter venoso central de longa permanência em pacientes submetidos à hemodiálise convencional em um hospital público de ensino e pesquisa. Método: pesquisa quantitativa, exploratório-descritiva, realizada em um Centro de Diálise, em São Paulo, Brasil entre novembro e dezembro/2019. Calculou-se o custo direto médio multiplicando-se o tempo despendido por profissionais de saúde pelo custo unitário da mão de obra direta, somando-se aos custos de insumos. Resultados: o custo direto médio total correspondeu a US$134,56 (DP±3,65), sendo US$107,01 (DP±0,23) relativos ao custo com material, US$22,10 (DP±3,63) com a mão de obra direta da equipe de inserção do cateter, US$4,65 (DP±0,00) com custo de medicamentos e US$0,80 (DP±0,15) com custo de soluções. Conclusão: constatou-se o impacto dos custos com recursos materiais e a imprescindibilidade da sua alocação racional, especialmente nos hospitais públicos de ensino e pesquisa, que possuem recursos financeiros limitados.

RESUMEN Objetivo: identificar el costo directo de la inserción de catéteres venosos centrales de larga duración en pacientes sometidos a hemodiálisis convencional en un hospital público de enseñanza e investigación. Método: investigación cuantitativa exploratoria-descriptiva realizada en un Centro de Diálisis de São Paulo, Brasil, entre noviembre y diciembre/2019. El costo directo medio se calculó multiplicando el tiempo empleado por los profesionales de la salud por el costo unitario de la mano de obra directa, sumando los costos de los insumos. Resultados: el costo directo medio total fue de 134,56 dólares (SD±3,65), de los cuales 107,01 dólares (SD±0,23) fueron costos de material, 22,10 dólares (SD±3,63) fueron costos de mano de obra directa del equipo de inserción de catéteres, 4,65 dólares (SD±0,00) fueron costos de medicación y 0,80 dólares (SD±0,15) fueron costos de solución. Conclusión: se ha constatado el impacto de los costos de los recursos materiales y la importancia de su asociación racional, especialmente en los hospitales públicos de enseñanza e investigación, que cuentan con recursos financieros limitados.

ABSTRACT Objective: to identify the average direct cost of long-term central venous catheter insertion in patients undergoing conventional hemodialysis in a public teaching and research hospital. Method: quantitative, exploratory-descriptive research, conducted in a Dialysis Center in São Paulo, Brazil between November and December/2019. The average direct cost was calculated by multiplying the time spent by health professionals by the unit cost of direct labor, adding to the costs of inputs. Results: The average total direct cost was US$134.56 (SD±3.65), of which US$107.01 (SD±0.23) for material costs, US$22.10 (SD±3.63) for direct labor of the catheter insertion team, US$4.65 (SD±0.00) for medication costs, and US$0.80 (SD±0.15) for solution costs. Conclusion: the impact of costs with material resources and the indispensability of their rational allocation was verified, especially in public teaching and research hospitals, which have limited financial resources.

Current and potential biotechnological applications of odorant-binding proteins.

Odorant-binding proteins (OBPs) are small soluble proteins whose biological function is believed to be facilitating olfaction by assisting the transport of volatile chemicals in both vertebrate and insect sensory organs, where they are secreted. Their capability to interact with a broad range of hydrophobic compounds combined with interesting features such as being small, stable, and easy to produce and modify, makes them suitable targets for applied research in various industrial segments, including textile, cosmetic, pesticide, and pharmaceutical, as well as for military, environmental, health, and security field applications. In addition to reviewing already established biotechnological applications of OBPs, this paper also discusses their potential use in prospecting of new technologies. The development of new products for insect population management is currently the most prevailing use for OBPs, followed by biosensor technology, an area that has recently seen a significant increase in studies evaluating their incorporation into sensing devices. Finally, less typical approaches include applications in anchorage systems and analytical tools. KEY POINTS: • Odorant-binding proteins (OBPs) present desired characteristics for applied research. • OBPs are mainly used for developing new products for insect population control. • Incorporation of OBPs into chemosensory devices is a growing area of study. • Less conventional uses for OBPs include anchorage systems and analytical purposes. Graphical Abstract.

Phylogenetic analysis of the ATP-binding cassette proteins suggests a new ABC protein subfamily J in Aedes aegypti (Diptera: Culicidae).

BACKGROUND: We performed an in-depth analysis of the ABC gene family in Aedes aegypti (Diptera: Culicidae), which is an important vector species of arthropod-borne viral infections such as chikungunya, dengue, and Zika. Despite its importance, previous studies of the Arthropod ABC family have not focused on this species. Reports of insecticide resistance among pests and vectors indicate that some of these ATP-dependent efflux pumps are involved in compound traffic and multidrug resistance phenotypes. RESULTS: We identified 53 classic complete ABC proteins annotated in the A. aegypti genome. A phylogenetic analysis of Aedes aegypti ABC proteins was carried out to assign the novel proteins to the ABC subfamilies. We also determined 9 full-length sequences of DNA repair (MutS, RAD50) and structural maintenance of chromosome (SMC) proteins that contain the ABC signature. CONCLUSIONS: After inclusion of the putative ABC proteins into the evolutionary tree of the gene family, we classified A. aegypti ABC proteins into the established subfamilies (A to H), but the phylogenetic positioning of MutS, RAD50 and SMC proteins among ABC subfamilies-as well as the highly supported grouping of RAD50 and SMC-prompted us to name a new J subfamily of A. aegypti ABC proteins.

Orthopedic findings in arthrogryposis and congenital Zika syndrome: A case series.

BACKGROUND: Congenital arthrogryposis (CA) consists of congenital joint contractures that affect at least two joints in different parts of the body. Approximately, 80% of CA cases are neurogenic, with changes to the formation, structure or functioning of the central and/or peripheral nervous systems. Most abnormalities are triggered either by motoneurons decreased activation in the corticospinal tract or by direct motoneurons injury. There had been few reports in the literature correlating congenital infection in humans with arthrogryposis until 2015. CA has recently been described associated with congenital Zika syndrome (CZS). METHODS: The objective of this study was to investigate and describe accurately the arthrogrypotic alterations in infants diagnosed with CZS and thus, suggest a possible pattern of orthopedic impairment. A total of 198 medical records of infants with CZS were evaluated. According to inclusion and exclusion criteria, 17 infants were included in the present study. Arthrogrypotic joints were orthopedically evaluated in four segments: right, left, upper, and lower limbs. All the four segments were assessed independently. RESULTS: Flexed wrists were the most frequently observed manifestation, associated with ulnar deviation (35.29%). Deformities were also commonly found in the third and fourth fingers (64.70%). Hip dislocation was found in 58.82% of the patients and talipes equinovarus and equinovalgus ankles were found in 29.41 and 23.52%. CONCLUSION: There was a particular pattern of joint impairment related to CZS and arthogrypotic alterations of infants evaluated in this study.

RANK/RANKL/OPG gene polymorphisms and loss of orthodontic mini-implants.

OBJECTIVE: To investigate the association of genetic polymorphisms (tagSNPs type) of RANK/RANKL/OPG genes with the loss of orthodontic mini-implants (MIs). SETTING AND SAMPLE POPULATION: One hundred and thirty-five patients of both sexes, with mean age of 48.7 ± 10 (20-76 years), were studied. The control group was composed of 104 patients, with no MI lost and functioning for at least 6 months and the case group, of 31 patients with at least one MI lost. MATERIALS AND METHODS: Cells were obtained by mouthwash with 3% glucose solution for 1 minute and scraping the buccal mucosa with sterilized spatula. DNA was extracted from buccal epithelial cells with 10 M ammonium acetate and 1 mM EDTA. Genotyping was performed by the real-time polymerase chain reaction (PCR) technique. Univariate and multivariate analyses were performed (P < .05). RESULTS: No markers were associated with MI loss after Benjamini and Hochberg false discovery rate correction of Univariate tests. In the multivariate analysis, the variables that associated with MI loss were the number of MIs installed (P < .000) and the polymorphism rs8086340 in the RANK gene (P = .018). CONCLUSION: A higher number of MIs installed (P < .000) and polymorphism rs8086340 in the RANK gene (P = .018) were associated with loss of orthodontic MIs after multivariate analysis.

Diaphragmatic paralysis: Evaluation in infants with congenital Zika syndrome.

BACKGROUND: Paralysis of the diaphragm in newborn infants can lead to recurrent infections and life-threatening respiratory insufficiency. The clinical diagnosis of unilateral diaphragmatic paralysis has been reported in infants with laboratory evidence of congenital Zika virus infection and/or the congenital Zika syndrome (CZS) phenotype but no evaluation of phrenic nerve function has been described. All reported infants have had accompanying arthrogryposis. High infant mortality is reported. METHODS: The causal mechanism of congenital diaphragmatic paralysis was evaluated in three infants with arthrogryposis as a manifestation of CZS (two of the three infants had laboratory evidence of ZIKV infection shortly after birth; the remaining infant had negative serology for ZIKV when first tested at 7 months of age). Electromyography and phrenic nerve compound muscle action potential (CMAP) were performed in all infants with diaphragmatic paralysis demonstrated on imaging studies. RESULTS: All infants had evidence of moderate chronic involvement of peripheral motor neurons. Phrenic nerve CMAP was reduced on the side of the diaphragmatic paralysis in two infants and reduced bilaterally in the remaining infant who had primarily anterior involvement of the diaphragm. All three infants had multiple medical complications and one infant died at 18 months of age. CONCLUSION: Evaluation of three infants with CZS and diaphragmatic paralysis demonstrated phrenic nerve dysfunction. In these and other affected infants, arthrogryposis appears to be a constant co-occurring condition and health problems are significant; both conditions are likely due to involvement of the peripheral nervous system in some infants with CZS.

Evaluation of the effects of humic acids on maize root architecture by label-free proteomics analysis.

Humic substances have been widely used as plant growth promoters to improve the yield of agricultural crops. However, the mechanisms underlying this effect remain unclear. Root soluble protein profiles in plants 11 days after planting and cultivated with and without humic acids (HA, 50 mg CL-1), were analyzed using the label-free quantitative proteomic approach. Cultivation of maize with HA resulted in higher fresh weight of roots than in untreated plants (control). Plants treated with HA showed increased number, diameter and length of roots. In the proteomics analysis, differences were detected in the following categories: energy metabolism, cytoskeleton, cellular transport, conformation and degradation of proteins, and DNA replication. Thirty-four proteins were significantly more abundant in the seedlings treated with HA, whereas only nine proteins were abundant in the control. The effects on root architecture, such as the induction of lateral roots and biomass increase were accompanied by changes in the energy metabolism-associated proteins. The results show that the main effect of HA is protective, mainly associated with increased expression of the 2-cys peroxidase, putative VHS/GAT, and glutathione proteins. Indeed, these proteins had the highest fold-difference. Overall, these results improve our understanding of the molecular mechanisms of HA-promoted plant growth.

Influence of facial patterns on the masticatory function and quality of life of completely edentulous patients during the transition to implant-retained mandibular overdentures.

STATEMENT OF PROBLEM: Although implant-retained mandibular overdentures (IMOs) provide functional benefits, the influence of the vertical facial pattern (FP) and the anteroposterior skeletal discrepancy (ASD) on the masticatory function and patient-centered outcomes during the transition to IMOs is still uncertain. PURPOSE: The purpose of this interventional clinical study was to evaluate the influence of the FP and ASD on the masticatory function, oral health-related quality of life (OHRQoL), and satisfaction of completely edentulous patients before and after transition to IMOs. MATERIAL AND METHODS: Cephalometric analysis was performed on 42 participants before treatment. Ricketts analysis was used to classify the FP, and the maxillomandibular relationship to the base of the skull determined the ASD. Masticatory performance (MP) and swallowing threshold (ST) test results were evaluated by the multiple sieve method by using artificial test food (Optocal cubes) to determine the median particle size (×50), homogenization index (B), and masticatory efficiency based on sieves 5.6 (ME: 5.6) and 2.8 (ME: 2.8). OHRQoL and satisfaction were evaluated by using the Dental Impact on Daily Living questionnaire. The data were analyzed using mixed-effects linear regression models to estimate the effect of time, FP, ASD, age, and sex on MP, ST, and OHRQoL. RESULTS: The MP, ST, OHRQoL, and satisfaction improved significantly after IMO loading, irrespective of FP and ASD. However, MP outcomes were most negatively affected mainly among dolichofacial (B and ME: 2.8), class II, and class III (×50, B, and ME: 2.8) participants. The ST test showed that class II participants still showed inferior ×50 values and performed a lower number of cycles than class I and class III participants. Women presented reduced masticatory function for all MP and ST outcomes and reported lower coefficients for appearance and general performance domains than men. CONCLUSIONS: The MP test detected more subtle improvements than the ST test, especially in class III participants. The class II participants benefited the least from the IMO installation according to the ST test. The IMO treatment improved the OHRQoL and satisfaction of edentulous patients, irrespective of the FP or ASD.

RNAi-based bioinsecticide for Aedes mosquito control.

Zika virus infection and dengue and chikungunya fevers are emerging viral diseases that have become public health threats. Their aetiologic agents are transmitted by the bite of genus Aedes mosquitoes. Without effective therapies or vaccines, vector control is the main strategy for preventing the spread of these diseases. Increased insecticide resistance calls for biorational actions focused on control of the target vector population. The chitin required for larval survival structures is a good target for biorational control. Chitin synthases A and B (CHS) are enzymes in the chitin synthesis pathway. Double-stranded RNA (dsRNA)-mediated gene silencing (RNAi) achieves specific knockdown of target proteins. Our goal in this work, a new proposed RNAi-based bioinsecticide, was developed as a potential strategy for mosquito population control. DsRNA molecules that target five different regions in the CHSA and B transcript sequences were produced in vitro and in vivo through expression in E. coli HT115 and tested by direct addition to larval breeding water. Mature and immature larvae treated with dsRNA targeting CHS catalytic sites showed significantly decreased viability associated with a reduction in CHS transcript levels. The few larval and adult survivors displayed an altered morphology and chitin content. In association with diflubenzuron, this bioinsecticide exhibited insecticidal adjuvant properties.

Bone response after immediate placement of implants in the anterior maxilla: a systematic review.

PURPOSE: The objective of this systematic review was to assess the three-dimensional changes in bone tissue after immediate installation of a single implant in a fresh extraction socket in the anterior maxilla. METHODS: After defining a strategy, an electronic search was carried out using the databases PubMed, Embase, LILACS, Web of Science, Cochrane, and Scopus. In addition, the gray literature was also researched using Google Scholar and ProQuest. Two reviewers independently screened for eligible studies, assessed the methodological quality, and extracted the data. The inclusion criteria were observational studies and experimental studies that assessed bone response after the immediate installation of a single implant in a fresh extraction socket, immediately loaded or not, in the region between the maxillary canines. Studies were included in any language, with no publication date restrictions and with a minimum of 6 months of follow-up after the surgical procedure. RESULTS: From a total of 3272 articles, only 12 studies met the inclusion criteria and were selected for the review. Bone remodeling after immediate installation of a dental implant was assessed using standardized periapical radiographs and cone beam computed tomography (CBCT). CONCLUSION: It can be concluded that bone remodeling occurs after tooth extraction and immediate implant installation.

Implante imediato com a técnica Socket Shield ­ relato de uma complicação / Immediate implants according to Socket Shield technique ­ report of a complication

A técnica socket shield é descrita como a retenção parcial de uma raiz em combinação com a instalação imediata de implantes. Tem como justificativa principal a manutenção do tecido ósseo vestibular em áreas estéticas. O objetivo deste artigo é relatar um caso clínico no qual uma série de implantes foi instalado, entre eles, um de acordo com a técnica socket shield e descrever uma situação clínica observada. Em avaliação clínica e tomográfica, após um ano em função, observou-se o deslocamento do fragmento radicular com reabsorção da parede óssea vestibular, porém sem sintomatologia clínica ou perda de função do implante. A pressão exercida durante a instalação do implante provocou o deslocamento do remanescente dentário. Posteriormente, em acompanhamento de 3 anos, observou-se manutenção e estabilização do fragmento deslocado. Pode ser concluído que a pressão exercida durante a instalação do implante provocou o deslocamento gradativo do remanescente dentário mantido propositalmente durante a instalação de um dos implantes. Porém, a prótese implantossuportada manteve-se em função (AU).

Socket shield technique is described as the partial retention of a root fragment combined to the immediate installation of an implant. It is justified by the maintenance of bone tissue in aesthetic areas. The aim of this paper is to report a clinical case in which a series of implants was inserted, one of them according to the socket shield technique, and to describe a related complication. In a clinical and tomographic evaluation, after one year in function, it was observed the displacement of the root fragment with reabsorption of the vestibular bone wall, but with no clinical symptomatology or loss of implant function. Afterwards, in the 3-year follow-up, it was observed maintenance and stabilization of the displaced fragment. It can be concluded that there was a complication in the technique observed by the buccal displacement of the intentionally left root fragment during the insertion of one implant. Nevertheless, the implant supported prosthesis remained in function (AU).

Retrospective evaluation of the survival rate of single tooth prostheses supported in external hexagonal implants: mean follow-up of 9 years / Avaliação retrospectiva do índice de sobrevivência de próteses unitárias suportadas em implantes de hexágono externo: média de acompanhamento de 9 anos

Introduction: The use of osseointegrated dental implants for the rehabilitation of patients has revolutionized dentistry. Objective: To retrospectively evaluate the survival rate and the frequency of complications with external hexagon platform supporting single crowns. Material and method: Dental forms of 110 patients who received 143 implants at the Ilapeo College (2004-2015) were used. The variables were: age, gender, systemic involvement at the time of surgery, region, implant design, type of surface, fixation system, pillar type and prosthesis material. The outcome variables were the incidence of complications in the implant or prosthesis and time in use. The mean follow-up period was 9 years. Result: 32.8% had some systemic disease. Ninety-six implants (67.1%) were installed in the maxilla and 47 (32.9%) in the mandible, 87 (60.8%) were in the posterior region and 56 (39.2%) in the anterior region, while 40 (28%) were placed in regions that had received bone reconstruction. The majority (97.2%) of the implants presented surface treatment, 42% had a cylindrical design and 58% were tapered. The majority of the prosthetic components (89.6%) used were UCLAs and most of the prostheses were fused-to-metal (79.7%). The rate of prosthetic complications was 19.58% and three implants had been lost (97.9% survival rate). There was no statistical difference between the variables analyzed for both the occurrence of prosthetic complications and for the loss of the implant. Conclusion: Implants with external hexagon connection were an effective and predictable option to support crowns and had high survival rates.

Introdução: O uso de implantes dentários osseointegrados para a reabilitação de pacientes revolucionou a Odontologia. Objetivo: Avaliar retrospectivamente o índice de sobrevivência e a frequência de complicações com plataformas de hexágono externo suportando coroas unitárias. Material e método: Foram utilizados prontuários de 110 pacientes que receberam 143 implantes na Faculdade Ilapeo (2004-2015). As variáveis foram: idade, sexo, envolvimento sistêmico no momento da cirurgia, região, desenho do implante, tipo de superfície, sistema de fixação, tipo de pilar e material da prótese. As variáveis de desfecho foram a incidência de complicações nos implantes e/ou próteses e o tempo em função. O tempo médio de acompanhamento foi de 9 anos. Resultado: 32,8% apresentavam alguma alteração sistêmica. Noventa e seis implantes (67,1%) foram instalados na maxila e 47 (32,9%) na mandíbula, 87 (60,8%) estavam em região posterior e 56 (39,2%) em região anterior, enquanto 40 (28%) necessitaram reconstrução óssea prévia. A maioria dos implantes (97,2%) apresentava tratamento de superfície, 42% eram cilíndricos e 58% cônicos. A maioria dos componentes protéticos (89,6%) eram UCLAs e a maioria das próteses fundidas em metal (79,7%). O índice de complicações protéticas foi de 19,58% e 3 implantes foram perdidos (97,9% de índice de sobrevivência). Não houve diferença estatística em relação às variáveis estudadas e a ocorrência de complicações protéticas e perda de implantes. Conclusão: Implantes com plataforma de hexágono externo são uma opção efetiva e previsível de reabilitação unitária e apresenta elevado índice de sobrevivência.

History, epidemiology and diagnostics of dengue in the American and Brazilian contexts: a review.

Dengue virus (DENV), an arbovirus transmitted by mosquitoes, has become a major threat to American human life, reaching approximately 23 million cases from 1980 to 2017. Brazil is among the countries most affected by this terrible viral disease, with 13.6 million cases. DENV has four different serotypes, DENV1-4, which show a broad clinical spectrum. Dengue creates a staggering epidemiological and economic burden for endemic countries. Without a specific therapy and with a commercial vaccine that presents some problems relative to its full effectiveness, initiatives to improve vector control strategies, early disease diagnostics and the development of vaccines and antiviral drugs are priorities. In this study, we present the probable origins of dengue in America and the trajectories of its spread. Overall, dengue diagnostics are costly, making the monitoring of dengue epidemiology more difficult and affecting physicians' therapeutic decisions regarding dengue patients, especially in developing countries. This review also highlights some recent and important findings regarding dengue in Brazil and the Americas. We also summarize the existing DENV polymerase chain reaction (PCR) diagnostic tests to provide an improved reference since these tests are useful and accurate at discriminating DENV from other flaviviruses that co-circulate in the Americas. Additionally, these DENV PCR assays ensure virus serotyping, enabling epidemiologic monitoring.

Maximum Bite Force of Edentulous Patients before and after Dental Implant Rehabilitation: Long-Term Follow-Up and Facial Type Influence.

PURPOSE: (1) To evaluate patients' long-term maximum bite force (MBF) after rehabilitation with mandibular implant-supported prosthesis, (2) to assess the influence of facial pattern in MBF, and (3) to evaluate the relation between the dominant chewing side and MBF. MATERIALS AND METHODS: Twenty-nine patients were selected. Pre- (T0) and immediate post-rehabilitation (T1) data of MBF were collected. In a follow-up visit 3 to 5 years after rehabilitation (T2), 24 patients participated. The patients were asked about dominant chewing side, and facial pattern was obtained by the initial lateral radiographs. RESULTS: There was statistically significant increase in MBF in T1 - T0 = 5.4 ± 4.3 kgf, T2 - T1 = 5.5 ± 6.0 kgf. There was no statistically significant difference in MBF considering facial type, brachyfacial (T0 = 4.4, T1 = 10.7, T2 = 17.6 kgf), mesofacial (T0 = 4.1, T1 = 9.7, T2 = 16.5 kgf), and dolichofacial (T0 = 3.4, T1 = 7.9, T2 = 12.6 kgf). CONCLUSIONS: There was no statistically significant relation between MBF and the dominant chewing side. It can be concluded that mandibular rehabilitation with dental implants improves MBF independent of the facial pattern and dominant chewing side.